Psychiatry International

Background: The perinatal period is a critical phase in a woman’s life, during which cultural and contextual factors significantly influence her physical and emotional well-being, as well as her transition to motherhood. Understanding cultural differences—such as those between Brazil and Spain—is essential for improving tailored perinatal care. Objective: This study explores and compares the perinatal experiences of women in Spain and Brazil, with a focus on their postpartum support needs and mental health implications. Method: A qualitative design was employed, using in-depth interviews with 22 postpartum women—11 from Spain and 11 from Brazil. Interviews were conducted using a semi-structured guide, and the data were analyzed through thematic analysis. Results: Common themes across both cultural contexts included the importance of preparation for childbirth, the need for emotional and psychological support, challenges related to breastfeeding, and adjustments to physical and psychological changes. Cultural differences were also identified: Brazilian women tended to engage in more detailed planning and valued the support of professionals such as doulas and midwives, whereas Spanish women emphasized the importance of having their choices respected during childbirth. Notably, both groups experienced significant emotional challenges, highlighting crucial considerations for maternal mental health. Conclusions: These findings emphasize the need for culturally sensitive perinatal support programs that address the emotional and psychological needs of postpartum women, aiming to improve mental health outcomes. Full article

Divorce represents a significant life transition with implications for emotional well-being, social integration, and economic security. This study examines the post-divorce experiences of women in Abu Dhabi, focusing on four challenges: financial insecurity, emotional distress, co-parenting difficulties, and struggles in forming new relationships. Drawing on data from the 5th Cycle of the Abu Dhabi Quality of Life Survey (n = 4347), the study explores how these challenges affect indicators such as life satisfaction, mental health, social trust, and financial stability. The findings show financial insecurity is the most prevalent and detrimental issue, particularly among older and less-educated women. Co-parenting stress peaks among women aged 35–49, while non-Emirati women report heightened financial vulnerability. Emotional distress is associated with poor sleep, reduced trust, and digital coping behaviors. Older women face greater social reintegration challenges. Religious practice emerges as a frequent coping mechanism, especially among those experiencing stigma and isolation. Guided by the Stress Process Model, the study highlights the interplay of social and psychological stressors and offers practical insights for psychiatric and mental health practitioners supporting women through family disruption. Full article

This study aimed to investigate the mediating effects of depression and interpersonal contact on the association between cognitive function and activities of daily living (ADL) in older adult patients with dementia. This descriptive cross-sectional study used the 2020 Korea Elderly Survey and included 189 older adults aged 65 years who were diagnosed with dementia by a physician. The analysis involved descriptive statistics and correlation analysis with Statistical Package for the Social Sciences (SPSS) version 24.0, and the dual mediation effect was analyzed with PROCESS Macro for SPSS version 3.5 Model 6. Cognitive function was negatively related to both ADL and depression but positively correlated with interpersonal contact. ADL exhibited positive and negative correlations with depression and interpersonal contact, respectively. Cognitive function significantly affected ADL and depression. Cognitive function significantly affected interpersonal contact, but depression was not significant. Finally, cognitive function exhibited a significant effect on ADL, but depression and interpersonal contact were not significant. Cognitive function showed the greatest effect on ADL in older adults diagnosed with dementia. Therefore, a program to prevent cognitive decline in older adults with dementia needs to be developed. Additionally, further studies are warranted to investigate the factors that affect the association between cognitive function and ADL in older adults with dementia. Full article

Public safety personnel (PSP) are known to experience difficult and demanding occupational environments, which were further complicated by the COVID-19 crisis. While public safety research typically focuses on the impact of operational stressors on PSP functioning and wellbeing, relatively less is known about the types and impacts of organizational stressors and how all these affect social wellbeing during the pandemic. The current study surveyed Canadian firefighters (n = 123), paramedics (n = 246), and public safety communicators (n = 48) that continued to serve the public over the course of the pandemic. Participants responded to two open-ended survey questions about how COVID-19 affected their lives at work and home. Using an inductive thematic analysis approach, responses were coded to identify emergent, data-driven themes while drawing on existing theory for analysis. Across occupational groups, qualitative analyses revealed that the public safety measures imposed by the COVID-19 pandemic further exacerbated existing operational and organizational strains, including increased exposure to distressing calls, absenteeism and coping with alcohol, and a lack of support from management. Participants also identified financial strain and housing insecurity as stressors, as well as frustration and helplessness at others’ non-compliance with public health advisories and protocols. Communication surrounding the rationale behind government decision-making, the efficacy of serology tests, and rates of infection were also identified. Together, these findings offer a nuanced understanding of the interplay among operational, organizational, and social stressors experienced by Canadian PSP during the COVID-19 pandemic, illuminating their impact on mental health and wellbeing, and identifying targeted areas of focus for future planning and meaningful intervention to support PSP wellness. Full article

The COVID-19 pandemic disproportionately impacted youth with chronic physical illness (CPI) and their caregivers. Emerging research aimed at understanding the impacts of the pandemic on this population is predominantly quantitative, lacking qualitative insights. This study used a qualitative approach to examine the experiences of COVID-19 among youth with CPI and their families, exploring how the pandemic impacted their mental health and use of mental health services. Using a constructivist paradigm and a phenomenological approach, semi-structured interviews were conducted with youth with CPI (n = 8) and their primary caregiver (n = 13) between March 2021 and May 2021. Thematic analysis was used to identify three key themes: (1) mental health impact on youth, (2) caregiver mental health declines, and (3) variability in the experiences of mental healthcare. The findings highlight the heightened depression, anxiety, and stress among youth with CPI and their caregivers, exacerbated by loneliness, uncertainty, and social restrictions, while also revealing that virtual mental healthcare was perceived as less effective than in-person care, which was valued for its human connection, privacy, and comfort. These results emphasize the need for improved, comprehensive mental healthcare and the adoption of family-centred care models to strengthen caregiver–youth relationships and better integrate physical and mental healthcare to improve health outcomes for this population. Full article

Introduction: Mental health conditions include disorders, diseases, problems, and/or symptoms that affect an individual’s emotions, thoughts, and/or behaviors, such as anxiety, depression, and substance use disorders. When describing the etiology of mental health conditions, various factors are often considered, including genetic, biomedical, social, and environmental. Therefore, the theoretical framework through which mental health conditions are discussed is important to consider, as it directly affects the conceptualization and treatment of mental health conditions. This narrative review synthesized the existing literature on different theoretical frameworks that can be used to understand the etiology of mental health conditions. Methods: This review employed a pragmatic, narrative approach to literature synthesis. Google Scholar was searched using variations of the terms “theory”, “mental health”, “etiology”, and “resilience” to locate the relevant peer-reviewed literature. The identified literature was further mined for additional important evidence sources. Results: Six theoretical frameworks were identified and discussed, including (1) attachment theory, (2) intersectionality theory, (3) intergenerational theory, (4) queer theory, (5) social cognitive theory, and (6) resilience theory. Strengths and weaknesses of each theoretical framework are identified. Conclusions: Although overlap exists among these theories, the different theoretical frameworks influence the conceptualization and treatment of mental health conditions. This has important implications since perceptions about the etiology and treatment of mental health conditions can be influenced by the theoretical perspective that one adopts. Some theoretical frameworks focus predominantly on psychosocial versus biological mechanisms, or vice versa, alluding to the need for interdisciplinary collaboration to best understand the etiology and treatment of mental health conditions. Full article

Background: Cognitive decline during aging is a factor that inevitably affects everyone. In some older adults, cognitive function declines more rapidly to mild cognitive impairment (MCI) and eventually dementia. Our work aimed to determine the associations between suicide-related single-nucleotide genetic polymorphisms (SNPs) and cognitive function dynamics in people over 65 years old over a three-year follow-up. Suicide-related SNPs have already shown an association with dementia in our previous study. Methods: The present study included 66 participants over 65 without subjective cognitive decline. Cognitive impairment was assessed at two follow-up points (at the start of the study in 2020–2021 and 3 years later) using the Montreal Cognitive Assessment (MoCA). Patients were also genotyped for 16 SNPs. Results: We found associations between rs10898553 and rs165774 and MoCA 3-year dynamics, with a certain genetic variant related to more significant progression. For rs7982251, associations with scale scores were found, but no effect on its dynamics. Conclusions: The research focused on analyzing genetic factors of cognitive decline in healthy older adults without subjective cognitive decline. Identifying these markers can help predict the development of pathology at early stages and start timely treatment. Full article

Objective: This study aimed to assess the prevalence of depression and anxiety among patients with acute leukemia in Vietnam and to identify associated sociodemographic and clinical factors. Methods: A cross-sectional study was conducted at the Hematology and Blood Transfusion Center of Bach Mai Hospital, a national tertiary care facility in Hanoi, Vietnam. A total of 82 patients diagnosed with acute leukemia were recruited using a convenience sampling method. Data on sociodemographic characteristics (e.g., age, gender, residence, education, occupation, marital status, and income) and clinical information (e.g., leukemia type, treatment stage, comorbidities, substance use) were collected. Depression and anxiety were assessed using the Beck Depression Inventory (BDI) and Zung’s Self-Rating Anxiety Scale (SAS). Multivariate logistic and Tobit regression analyses were applied to explore associated factors. Results: Participants had a mean age of 43.4 years (SD = 14.0), with 53.7% male and 69.5% residing in rural areas. Most were married (82.9%) and had completed high school (45.1%). Farmers constituted the largest occupational group (29.3%). The mean BDI score was 13.7 (SD = 9.8), and the mean SAS score was 39.2 (SD = 6.3). Overall, 50.0% of patients met criteria for depression, while 26.8% exhibited clinically significant anxiety symptoms. Among those with anxiety, 59.1% had mild symptoms, 22.7% moderate, and 18.2% severe or very severe. Patients with education above high school (OR = 7.32; 95% CI: 1.01–53.23), a spouse (OR = 25.10; 95% CI: 2.14–294.55), or comorbidities (OR = 8.05; 95% CI: 1.63–39.68) had significantly higher odds of depression. A higher income (>10 million VND/month) was associated with lower depression scores (Coef. = −6.05; 95% CI: −11.65 to −0.46). Regarding anxiety, the female gender was associated with higher odds (OR = 3.80; 95% CI: 1.21–11.93) and SAS scores (Coef. = 4.07; 95% CI: 1.64–6.51), while higher income predicted lower anxiety severity (Coef. = −3.74; 95% CI: −6.57 to −0.91). Conclusions: This Vietnamese hospital-based study highlights a high prevalence of depression and anxiety among patients with acute leukemia. Routine mental health screening and culturally appropriate psychosocial interventions are strongly recommended to improve patient well being. Full article

This review aimed to evaluate the effects of dietary interventions on depressive symptoms, quality of life (QOL), and daily functioning in adolescents and young adults with depression. We searched PubMed, Web of Science, and CENTRAL on 17 August 2024. Participants aged 13–40 years with depression, receiving dietary interventions, and enrolled in randomised controlled trials published in English after 2000 were included. For the meta-analysis of depressive symptoms, pooled Hedges’ g was calculated. Five studies involving 288 participants were included in this review, with three showing significant improvements in depressive symptoms favouring the intervention group. Three studies were included in the meta-analysis, which demonstrated a nonsignificant effect (Hedges’ g = −0.45; 95% CI: −1.29, 0.39; p = 0.2946) and high heterogeneity (I² = 88%). One study reported significant improvements in QOL, and another showed enhancements in executive function, both favouring the intervention group. All included studies reported high adherence to the intervention or low dropout rates. Dietary interventions are highly acceptable to adolescents and young adults with depression and might help improve their depressive symptoms and QOL. However, the results should be interpreted cautiously due to high heterogeneity and the limited number of included trials. Full article

The decline in mental health among workers in Japan has become a serious concern. Autism spectrum disorder (ASD) traits are increasingly recognized as a potential risk factor for mental health issues, yet few individuals receive a formal ASD diagnosis. This study aims to examine whether undiagnosed but working individuals with strong ASD characteristics differ in factors related to presenteeism (low productivity) compared to their counterparts with fewer ASD traits. In particular, we investigated the impact of social camouflaging—the behavioral adaptation used to mask ASD traits—especially on workers with strong ASD characteristics. An online survey was conducted among white-collar workers aged 20 to 60. The survey included items collecting demographic information (gender, age, marital status, highest level of education completed, employment status, job title, length of employment, and working hours) and included the Japanese versions of four validated instruments to measure aspects of autism traits, social camouflaging, work functioning, and occupational stress. Of the 543 respondents, 139 (25.6%) exhibited strong ASD characteristics. These individuals reported lower productivity than their counterparts. While social camouflaging was observed across all ASD trait levels, it was specifically linked to poorer mental health and reduced productivity among workers with strong ASD characteristics. To support workplace well-being and productivity, it is crucial to increase awareness and understanding of ASD traits in professional settings and create an environment that accommodates diverse work styles. Full article

This study aimed to validate the usefulness of the Simplified Computerized Comprehensive Learning Ability Screening Test (SCLST) in schools and homes, to facilitate early detection and intervention for children with reading disorder (RD), math disorder (MD), or attention-deficit hyperactivity disorder (ADHD). Participants included 207 children and adolescents diagnosed with ADHD, RD, or MD and the healthy control group that was matched 1:1 by gender, age, and educational years. Higher rates of omission errors, commission errors, and standard deviation of response times were observed in the ADHD group (p < 0.001) in the SCLST-ADHD. The accuracy rates of the SCLST-RD and SCLST-MD were lower in the RD (p < 0.001) and MD group (p < 0.01), respectively. The mean response times were higher in the MD group (p < 0.001). In addition, the optimal sensitivity and specificity values were 84.6% and 88.5%, and the positive and negative predictive values were 88.0% and 85.2%, respectively, in the SCLST-ADHD. In the SCLTS-RD, the sensitivity and specificity values were 81.1% and 85.6%, and the positive and negative predictive values were 84.9% and 81.9%, respectively. In the SCLST-MD, the sensitivity and specificity values were 97.4% and 76.9%, and the positive and negative predictive values were 80.9% and 96.8%, respectively. Thus, by supporting timely assessment and intervention, this tool can support clinicians and educators in early-stage learning disabilities screening and reduce long-term psychosocial impairments. Full article

With over 720,000 people dying by suicide each year and many more attempting it, suicide events have become a significant public health concern. Individuals with depressive disorders are particularly at risk, as suicide is one of the most common preventable causes of death in this group. The aim of this study was to examine the relationship between psychological pain, health-related quality of life, and suicidal tendencies among patients with depressive disorder. The study included 73 patients hospitalized in the psychiatric ward at a University Psychiatric Hospital. To assess the observed variables, a battery of questionnaires was administered, consisting of a sociodemographic questionnaire and validated instruments, including Suicide Screening Questionnaire—Self Rating (SSQ-SR), the 36-Item Short Form Health Survey (SF-36), and the Mee–Bunney Psychological Pain Assessment Scale (MBPPA). A significant association was found between psychological pain, health-related quality of life, and suicidal tendencies. Higher levels of psychological pain and greater impairment in physical, emotional, and social functioning were associated with a higher presence of risk factors for suicide. Psychological pain, emotional well-being, and physical functioning were significant predictors of suicidal tendencies in individuals with depressive disorders. The results of this study emphasize the importance of psychological pain and specific aspects of health-related quality of life in both the prevention and treatment of suicide. Full article

Exposure therapy approaches are recognized as effective treatments for specific phobias; however, certain phobias, such as fear of driving on urban highways, present unique challenges in order to expose the patient to the triggering stimuli in a safe, accessible, and controlled manner. In this context, we developed a virtual reality (VR) computerized driving simulator based on a local urban highway, and an accompanying clinical protocol to provide exposure therapy for patients with observed fear of driving on urban highways. We recruited eleven patients for this pilot study, where safety and tolerability as well as clinical and functional improvement were explored. We found that the driving simulator was safe and well tolerated by patients, with a notable 82% of patients successfully completing in vivo exposure, and there being a consistent trend in reduced anxiety scores using standardized testing. Nine patients successfully engaged in live exposures in a real freeway after participating in this VR-based exposure therapy protocol. The creation of an immersive and realistic VR environment based on a local urban highway for treating this phobia proved feasible and well-tolerated by participants. The intervention’s ability to engage patients who might otherwise have avoided traditional exposure therapies is noteworthy. Future research should aim to replicate this study with a larger and more diverse sample to enhance the generalizability of the findings. Full article

The association between job stress and burnout among emergency physicians is not fully understood. This study aimed to examine the relationship between stressors and burnout among physicians working in tertiary emergency medical centers in Japan. A 2014 cross-sectional study with 256 Japanese emergency physicians from 75 tertiary emergency medical centers incorporated a job stress questionnaire and the Pines Burnout Measure. Multiple logistic regression analysis was performed to determine the odds ratios of job stress factors associated with an increased risk of burnout. Ninety-eight (38.3%) participants were classified as experiencing burnout. The results showed that emergency physicians in the burnout group experienced significantly high physical overload, high interpersonal conflict, low job control, and low job suitability as job stressors. Low supervisor and family/friend support was significantly associated with burnout. Free-response data suggested that factors such as “no discretion or decision-making power”, “awareness that I am not suitable for emergency medical care”, and “dealing with patients and their families” may have contributed to the state of burnout among Japanese emergency physicians before the COVID-19 pandemic. Given the anticipated return to pre-pandemic conditions, addressing the risk factors of burnout identified in this study may assist Japanese emergency physicians in preventing burnout. Full article

Background: high levels of stress have hazardous impacts on nurses’ health, well-being, job satisfaction, and abilities to cope with the job demands, which in turn may impact the provision of quality patient care, which is essential for universal health coverage. Aim: to investigate the relationship of perceived stress related to personality traits, chronotype, and eating behaviour among hospital and community nurses in Brunei. Methods: A cross-sectional survey on nurses from public hospitals and community health centres from all four districts in the country. The questionnaire included Perceived Stress Scale to measure stress levels, the brief Big Five Inventory to identify personality, the Morningness-Eveningness Questionnaire to identify chronotype, and the Sakata Eating Behaviour Questionnaire to identify eating behaviour. Subgroup analysis and partial least squares structural equation modelling were applied. Results: The structural equation model revealed that personality trait (β = 0.482) is the most salient and strongest factor contributing to perceived stress, followed by chronotype profile (β = 0.45), accounting for 71.4% of the variance explained for perceived stress. Whereas perceived stress (β = 0.719) is a factor affecting eating behaviour, which accounts for 51.6% of the variance explained for eating behaviour. Conclusions: This study revealed that neuroticism and evening chronotype are significant stress predictors. Stress affects eating habits, with stressed nurses showing poor eating patterns. Older and single nurses report higher stress. Full article

The COVID-19 pandemic presented many potentially traumatic circumstances. Research continues to investigate pandemic-related Post-traumatic Growth (PTG). However, most studies fail to fulfil the parameters of PTG whereby a triggering event must be of seismic intensity and have ceased before PTG can manifest, producing significant validity and reliability issues. The relationships between PTG, trait resilience and fear are also under-researched, particularly in circumstances where the parameters of PTG are met. This study examined the relationship between PTG, COVID-19-related fear and trait resilience. Participants (n = 229) completed an online questionnaire incorporating the Post-Traumatic Growth Inventory and the Connor–Davidson Resilience Scale. The sample participants were moderately traumatised with moderate–low PTG (M = 50.85). Participants reported greater levels of PTG compared to participants from pre-COVID studies, notably in relation to the constructs of Relating to Other (d = 0.29), New Possibilities (d = 0.47), Personal Strength (d = 0.39), and Spiritual Change (d = 0.29). Higher levels of resilience (B = 0.48) and COVID-19-related fear (B = 0.16) were associated with greater overall PTG. Younger participants also reported greater levels of PTG (B = −0.29). The findings advance current knowledge regarding the potential relationship between fear and PTG and demonstrate that trait resilience is a promotional factor, presenting opportunity for future intervention formulation. However, reform is required within the PTG literature pool. Future research investigating PTG must reach both parameters. In circumstances where this is impossible, research concerning newfound positive cognition during adverse circumstances should be re-explored as Post-Adversarial Appreciation (PAA) to maintain validity. Full article

Binge-watching has become a dominant mode of media consumption, yet its psychological underpinnings remain insufficiently explored. This study investigates the influence of dark triad personality traits, sociodemographic factors, and TV series preferences on binge-watching behavior. A Portuguese version of the Binge-Watching Engagement and Symptoms Questionnaire (BWESQ) was validated using a confirmatory factor analysis (CFA), demonstrating strong psychometric properties. Measurement invariance was confirmed across genders through a multigroup CFA, testing configural, metric, scalar, and error variance levels. Model reliability, convergent validity, and discriminant validity were assessed using Cronbach’s alpha, composite reliability, and the average variance extracted (AVE). Multiple linear regression analyses identified significant predictors of binge-watching, including gender, age, professional status, TV series preferences, Machiavellianism, and psychopathy. These findings underscore the role of personality traits and demographic factors in shaping binge-watching behavior, offering insights that may inform psychological interventions to prevent excessive or problematic viewing patterns. Full article

Early readmission to psychiatric units poses a significant challenge for both patients and healthcare institutions. It hampers patient progress and prognosis, and the professional approach taken during discharge can greatly influence the recovery process. This paper proposes a multicomponent discharge transition intervention to mitigate the risk of early readmission to a mental health hospitalization unit (MHHU). The present proposal consists of two distinct phases with two clearly differentiated main objectives. On the one hand, following an observational design, the development of a measurement instrument to assess patients’ risk of early readmission, allowing for stratification into the high-, medium-, and low-risk categories. On the other hand, according to a quasi-experimental design, the implementation and evaluation of the intervention program, with a focus on tailored interventions to ensure adherence and continuity of care post-discharge, with a more intensive approach for high-risk patients. A post-discharge psychotherapeutic group will also be introduced for high-risk cases to support recovery. The program’s effectiveness will be evaluated by comparing the early readmission rates at the Regional Hospital of Malaga’s MHHU to those of the previous year. Two other hospitals in the province, where the intervention is not applied, will serve as control groups. Success will also be measured through pre- and post-assessments of the recovery, functionality, subjective well-being, social support, and treatment satisfaction of those participating in the psychotherapeutic group. This proposal aims to address the issue of early readmission by enhancing predictability and understanding intervention strategies to reduce readmission rates. Full article

Neurotypical (NT) siblings of individuals with Autism Spectrum Disorder (ASD) experience complex emotional, psychological, behavioral, and social challenges. Understanding the factors that influence their well-being is essential for developing tailored interventions. This systematic review examines the psychological and social functioning of NT siblings and identifies protective and risk factors that impact their adaptation. A systematic search was conducted across EBSCO, PubMed, and Google Scholar, covering studies published between 2013 and 2024. Inclusion criteria focused on research investigating NT siblings’ emotional, psychological, behavioral, and social well-being. Thirty studies met the inclusion criteria and were synthesized narratively. Findings reveal heterogeneous experiences among NT siblings, ranging from increased empathy and resilience to heightened anxiety, depression, and social difficulties. The quality of sibling relationships and social support systems plays a pivotal role in moderating these outcomes. NT siblings represent a vulnerable group requiring family-centered interventions. Future research should adopt longitudinal and multi-informant approaches to explore long-term effects and culturally sensitive support strategies. Full article